What's ID, you ask? It's more than what I get asked for every time I want to see a rated-R movie or buy a pack of cigs (My for-real, I'm in an American Lung Association sponsored smoking cessation class quit date is Feb 3rd--wish me luck. In the interim, the woman at the corner store-- with what are apparently the early signs of dementia--asks me every single time, "What are you, in middle school?" No, ma'am. Just flat-chested and baby-faced. Moisturize, and you too could be mistaken for half your age!). It's Infectious Disease, y'all, and it's super cool.
Did you know there are more microbes in and on your body than there are cells that belong to you? So even if you're an atheist, or agnostic, or on a desert island...you're REALLY never alone. I know it's weird, but it's sort of a comforting thought. You, by yourself, are a community--an ecosphere all your own!
There are lots of microbes that live happily with you and don't cause any disease...it's called commensalism, or mutualism. Actually some bacteria even feed you--making Vitamin K in your intestines, for example. Others live on your skin and keep bad guys like MRSA (the nasty 'superbug' that's been in the news lately) from taking over...like your own little bacterial bouncer patrol.
And even bad bugs--enterococci that cause gastritis, para ejemplo--have some mechanisms of action that are truly amazing (sort of like how you hate the Bond villain in every movie but are frankly amazed at the intricacy and detail of his/her evil schemes): E. coli can actually get INTO your bladder cells and chill out there, evading detection. You get treated for a UTI, all the 'outside' bacteria are wiped out, but then there are these little 'seeds' of e. coli lying dormant-ish, waiting, and then BAM! Even though you haven't been reinoculated (ie, you haven't gotten more bacteria into your bladder by having sex and not peeing afterwards, or wiping back-to-front, or wearing tight pants, or whatever else is on the 'not-to-do' list these days) you're reinfected. Whoa. Take that, Mr. Bond.
Also, staphylococcus aureus is named that because 'aureus' is from the (Latin?) root for gold...y'know, Au? Remember the periodic table, kids?...and when you plate them out, the colonies are a brilliant gold color that's frankly stunning. I know I'm going to earn some weird looks for this, but especially when they're plated on blood agar, the contrasting colors are spectacular. I'd put a picture of that up in my living room, with the caveat that no one be allowed to ask what it is.
PS--No, I'm still totally married to psych, but ID is definitely, undeniably enthralling.
Thursday, January 22, 2009
Monday, January 19, 2009
It's the sarcasm patrol!
So this has been an awesome weekend.
Got an email from the doctor saying, yeah, we need to do an MRI. To check for--no shit!--a brain tumor.
Had a respiratory physiology take-home exam.
Couldn't start my car Saturday because it was too cold and the gas line had frozen up.
Went outside today to discover that someone had broken into my f*cking car.
And this week looks to be like a baguette--long and hard (well, maybe not AS long, since it's only 4 days).
Seriously, God. Not cool.
Got an email from the doctor saying, yeah, we need to do an MRI. To check for--no shit!--a brain tumor.
Had a respiratory physiology take-home exam.
Couldn't start my car Saturday because it was too cold and the gas line had frozen up.
Went outside today to discover that someone had broken into my f*cking car.
And this week looks to be like a baguette--long and hard (well, maybe not AS long, since it's only 4 days).
Seriously, God. Not cool.
Thursday, January 8, 2009
Breasts!
Knew that would get your attention. Anyway, it always gets mine.
But no, this is not about mammary glands, not really. Instead it's about the respiratory exam, which we learned to do today, and the delicate art of intergender examinations.
When we finally got up to our practice rooms to attempt the arts of "inspection, palpation, and auscultation" on one another (that sequence has been effectively drilled into my head now--thanks, Dr. R!) the question arose: same gender dyads to practice, or opposite, or both? As the preceptor said, "I know that for practice's sake it might be better to pair off male/female...but for comfort's sake, you'd probably rather do same-gender exams, right? Well, you've got five more years of practice ahead of you, so for now let's stick with comfort and do same-gender pairs." It's odd; everyone in the class knows what my orientation is (I think) but to date this hasn't caused any awkwardness, for which I am profoundly thankful. It's hard enough trying to learn how to percuss and listen for inspiratory splitting without worrying that your exam partner thinks you're surreptitiously trying to cop a feel. Which, it goes without saying (and for once I'm not being sarcastic) I would neeeeeever do, for approximately 573 reasons, among them professionalism, integrity, the fact that a lot of the women in my class could kick my ass if I tried such a thing, and the fact that I'm really not into the whole sexual assault business.
I was surprised, but the guys actually seemed more uptight about the idea of examining women than we did about the prospect of being palpated by gentlemen (and in fact all the men in my practice group are what I would call gentlemen). "I mean, how do you do the exam...with women?" one of the guys asked. To which our preceptor--a funny guy who I am 99.9% positive is gay, and whom I thus had no qualms about allowing to demonstrate part of the exam on me--said, "Well, the breasts are always going to be there." We all laughed at that, but it's true; I've never really been conscious of it, because I'd only ever been on the receiving end of physical exams before, and with my 32AAs there isn't much concern about impeding the progress of a physical (though there was the nurse who took an EKG and left my gown wide open until I yanked it closed...I was not pleased), but breasts can be cumbersome when you're trying to do a cardiac or respiratory exam. You may have to ask a woman to lift or move her breast, or if she can't, gently do it yourself. We're just learning about all this, so we still get awkward and blushy and worry that someone's going to be pissed at us. By third year, apparently, mammaries will be mammaries will be mammaries. It's all in the approach, I guess, in how the body is constructed and understood from a cultural perspective (and medicine--medical school especially--is definitely its own culture).
But no, this is not about mammary glands, not really. Instead it's about the respiratory exam, which we learned to do today, and the delicate art of intergender examinations.
When we finally got up to our practice rooms to attempt the arts of "inspection, palpation, and auscultation" on one another (that sequence has been effectively drilled into my head now--thanks, Dr. R!) the question arose: same gender dyads to practice, or opposite, or both? As the preceptor said, "I know that for practice's sake it might be better to pair off male/female...but for comfort's sake, you'd probably rather do same-gender exams, right? Well, you've got five more years of practice ahead of you, so for now let's stick with comfort and do same-gender pairs." It's odd; everyone in the class knows what my orientation is (I think) but to date this hasn't caused any awkwardness, for which I am profoundly thankful. It's hard enough trying to learn how to percuss and listen for inspiratory splitting without worrying that your exam partner thinks you're surreptitiously trying to cop a feel. Which, it goes without saying (and for once I'm not being sarcastic) I would neeeeeever do, for approximately 573 reasons, among them professionalism, integrity, the fact that a lot of the women in my class could kick my ass if I tried such a thing, and the fact that I'm really not into the whole sexual assault business.
I was surprised, but the guys actually seemed more uptight about the idea of examining women than we did about the prospect of being palpated by gentlemen (and in fact all the men in my practice group are what I would call gentlemen). "I mean, how do you do the exam...with women?" one of the guys asked. To which our preceptor--a funny guy who I am 99.9% positive is gay, and whom I thus had no qualms about allowing to demonstrate part of the exam on me--said, "Well, the breasts are always going to be there." We all laughed at that, but it's true; I've never really been conscious of it, because I'd only ever been on the receiving end of physical exams before, and with my 32AAs there isn't much concern about impeding the progress of a physical (though there was the nurse who took an EKG and left my gown wide open until I yanked it closed...I was not pleased), but breasts can be cumbersome when you're trying to do a cardiac or respiratory exam. You may have to ask a woman to lift or move her breast, or if she can't, gently do it yourself. We're just learning about all this, so we still get awkward and blushy and worry that someone's going to be pissed at us. By third year, apparently, mammaries will be mammaries will be mammaries. It's all in the approach, I guess, in how the body is constructed and understood from a cultural perspective (and medicine--medical school especially--is definitely its own culture).
Wednesday, January 7, 2009
Learning to laugh at my own stupidity--and Microbes!
So I slept essentially...not at all last night (ok, 5 hours) and that was from 4:30 to 9:30. That may not seem like much of a shortcoming to you late-night IMers and Conan O'Brien watchers (yes, I realize I just sounded like a geriatric patient, and secretly I am a 87 year old woman--you kids quit playing grabass on the lawn!), but I've got me some bipolar disorder, and I need my damn sleep. So I was not running on all however-many cylinders today, as became immediately (or, unfortunately, not-so-immediately) apparent when I went to pick up some essentials at the grocery store today. Never mind that the grocery store is kind of a fraught place for me, or that I have a rough time actually picking things up and putting them in the cart, or that I always feel like I'm in 15 different people's way...beyond all that intrinsic neurosis, I got to the check-out counter FINALLY, and when all was said and done...I didn't have my credit card with me. Got it out of my wallet to do God-knows-what with it and never put it back in, and had all of $7 in cash with me. So I did the whole stammering/turning red/sweating/sympathetic nervous system in overdrive thing, y'know, where you wish the earth would open up and swallow you down to the bowels of hell where at least you could hang out and drink absinthe with Oscar Wilde. So I muttered an apology and all but ran out the front door, my face a color somewhere between "rose" and "carmine" in the Martha Stewart interior decorating palette. Once I was home and finishing the last of a bottle of merlot I could look back at it and laugh, because it is sort of a ridiculous situation for a person who's obsessed with doing everything perfectly and never incoveniencing anyone to find herself in. Maybe I'm learning, little by little, to laugh at my shortcomings--at least those that don't kill anyone (please, please, universe, don't let there be any of the other kind!).
Also, had Microbes today for the first time, and it was so utterly kewl. We got a pack of these Microbe Cards to augment our learning process...like Pokemon or sports trading cards, with images of the infectious fungi, bacteria, viruses, or parasites in question on one side and information (from epidemiology to diagnosis to treatment) on the opposite side. I'm really looking forward to getting together a microbe card playing league..."I play N. gonorrhea!" "I play Cipro!" or "I play Hepatitis C!" "I play interferon!" Gonna be a +3 infectious disease specialist by the end (Note: I have never actually participated in an RPG and thus have no idea what I'm talking about...except for the microbes. I kind of know what I'm talking about there, but only to such an extent that I can sound reasonably intelligent at cocktail parties and probably be very dangerous to actual patients, which is why I'm not yet allowed in the same room with them without an M.D. chaperone).
Also, had Microbes today for the first time, and it was so utterly kewl. We got a pack of these Microbe Cards to augment our learning process...like Pokemon or sports trading cards, with images of the infectious fungi, bacteria, viruses, or parasites in question on one side and information (from epidemiology to diagnosis to treatment) on the opposite side. I'm really looking forward to getting together a microbe card playing league..."I play N. gonorrhea!" "I play Cipro!" or "I play Hepatitis C!" "I play interferon!" Gonna be a +3 infectious disease specialist by the end (Note: I have never actually participated in an RPG and thus have no idea what I'm talking about...except for the microbes. I kind of know what I'm talking about there, but only to such an extent that I can sound reasonably intelligent at cocktail parties and probably be very dangerous to actual patients, which is why I'm not yet allowed in the same room with them without an M.D. chaperone).
Sunday, January 4, 2009
No fumare
No smoking in...Italian, maybe?
Did you know nicotine is more addictive than heroin by most objective measures?
I did. And I'm trying to quit despite that knowledge. I went cold turkey once before, in college, and didn't smoke for 6 months...then stupidly, oh-so-stupidly, started again.
So right now, as I'm quitting (not trying to quit--quitting) I could kill someone--maybe myself, maybe an innocent bystander--with a spoon.
And so I was actually on the edge of breaking down and going to the corner store to get some nic sticks/coffin nails/ciggies/fags/whatever you call them, only to find (yeah, ha ha ha, Universe, really hilarious) that my ID is temporarily MIA. So no dice. This, to me, is a coincidence--but it's also an example of the Goddess saying, "You promised you were going to quit. Now sit your ass down and do some deep breathing." What a lesson in surrender.
Mysterious ways, indeed. I can't shake the feeling that Divinity has pinched my driver's license. Luckily I walk to school.
Did you know nicotine is more addictive than heroin by most objective measures?
I did. And I'm trying to quit despite that knowledge. I went cold turkey once before, in college, and didn't smoke for 6 months...then stupidly, oh-so-stupidly, started again.
So right now, as I'm quitting (not trying to quit--quitting) I could kill someone--maybe myself, maybe an innocent bystander--with a spoon.
And so I was actually on the edge of breaking down and going to the corner store to get some nic sticks/coffin nails/ciggies/fags/whatever you call them, only to find (yeah, ha ha ha, Universe, really hilarious) that my ID is temporarily MIA. So no dice. This, to me, is a coincidence--but it's also an example of the Goddess saying, "You promised you were going to quit. Now sit your ass down and do some deep breathing." What a lesson in surrender.
Mysterious ways, indeed. I can't shake the feeling that Divinity has pinched my driver's license. Luckily I walk to school.
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